Dave Burrows Director Situation in Bosnia and Herzegovina BiH Strategic Investment Framework Capacity Assessment Roadmap to Transition and Sustainability Overview GF HIV funding to end for ID: 162091
Download Presentation The PPT/PDF document "Costing and Sustainability of HIV/AIDS I..." is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
Costing and Sustainability of HIV/AIDS Interventions in Bosnia
Dave BurrowsDirectorSlide2
Situation in Bosnia and Herzegovina (BiH)Strategic Investment Framework
Capacity AssessmentRoadmap to Transition and SustainabilityOverviewSlide3
GF HIV funding to end for BiH in 2015
Independent Evaluation of National HIV Programme in BiH in 2013High priority recommendation: to develop a Transition and Sustainability Plan for HIV ProgrammingUNDP is PR, contracted APMG to develop plan
Situation in
BiHSlide4
Structure of BiH developed as key part of Dayton Peace Accord to end Bosnian war
BiH consists of 2 entities (Republic of Srpska or RS &
Federation of
BiH
or
FBiH
) & 1
autonomous district (Brčko)These 3 separate ‘governing bodies’ have a total of 183 ministries, each with a department, staff etcDevastating floods in May 2014
Situation in
BiHSlide5
Structures and strategies to address HIV and TB are considered the only effective national programs in
BiHEvaluation found that existing system of government & NGO partners have collaborated to keep BiH as a low-level HIV epidemic, preventing a concentrated epidemic
245
registered
HIV
cases (126 with AIDS) from population of 3.8m
HIV Situation in
BiHSlide6
Good expenditure, costs data from UNDP on GF-funded activitiesCounterpart financing more problematic:
Budgets available without disease-specific expenditure11 health insurance funds (HIFs)Varied estimates of those uninsuredLegal requirement for government to pay for uninsured, but no budget
Beyond HIFs, very little contribution from national sources to HIV funding
Health FinancingSlide7
FBiH: Government expenditure on health was only 25% of proposed budget
RS: greater expenditure but budget not publishedIn both entities, government expenditure on health is low; and none is directly relevant to the HIV Programme.Up to 40% of population not covered by HIFsOut-of-pocket payments common; 1 estimate = 40% of health care financing
Features of
BiH
health financingSlide8
EU/WB assessment found:Biggest floods in 120 years
Total economic impact: 3.98 billion BAM (2.03b Eu) = about 15% of GDPEconomy predicted to contract by 0.7% in 2014Will require about 500m BAM in recovery funds and 3b BAM for reconstruction
Difficult to see how
BiH
governments can increase investment in HIV in near future
Effects of floodsSlide9
Adapted tool on Country Ownership of HIV Care and Treatment, developed by USAID
Measured:Adequacy of human resources;Leadership;
Guidance
by effective policies;
F
unctioning of operating
systems (with an enabling environment);
Effectiveness of management systems;Sustainability of infrastructure and resourcesFiscal transparency and accountability
Capacity AssessmentSlide10
Capacity Assessment resultsSlide11
Identify all desirable
interventions of HIV programme with specific reference to key populations.
providing ART for PLHIV and treating OIs;
counselling and support for PLHIV and families of PLHIV;
treatment for prevention: providing ART for preventing HIV transmission among discordant couples;
providing HIV prevention services for women and girls who are pregnant;
focusing outreach on people at higher risk: PWID (including young people and women who use drugs), SWs and their clients (such as migrants, truck drivers) and MSM (including young men)
implementing
behaviour change programmes, including condom promotion for the general population with special emphasis on people with multiple partners, people engaging in casual sex, and young people.
Draft Road MapSlide12
Cost the components, including sub-components, with reference to workloads and expected outputs or measurable
achievementsThe key factors that will determine cost are:Size
and geographic spread of the target population. Note that, at present, there is uncertainty about the sizes of the various KAPs and epidemic levels;
E
xtent
of reach (i.e. the numbers of a targeted population that are reached with the available resources and where they are reached);
P
rices, which may be affected by inflation and/or exchange rate variances; andPossibility of sharing costs (particularly administrative functions).
Draft Road MapSlide13
Research potential funding sources and make initial projection of expected available financing.
Determine the extent to which components/sub-components from step 4 can be financed by the expected financing.
Examine
all sub-components to determine which, within the confine of the expected financing, should be included and which should be deferred until more financing can be secured.
Examine
the possible ways to raise finance.
Draft Road MapSlide14
Prepare a draft plan and budget based on projected funding (from actions to be taken under step 8) and projected costs of priority interventions that can be met from the projected funding.
Undertake a risk assessment and prepare a risk mitigation plan accordingly.
Review
costs to identify possibly cost savings (e.g. shared services, donated time).
Review
, on a regular basis, funding, population, epidemiological, health insurance contributions, inflation and other data/assumptions and update/edit the draft plan and budget accordingly.
Present
the final draft budget to NAB/CCM for approval.
Draft Road MapSlide15
Arlette Campbell White, UK
Mirza Musa, Bosnia and HerzegovinaAram Manukyan, Armenia
Oliver Campbell White, UK
Lou McCallum, Australia
Thanks to Co-AuthorsSlide16
APMGlobal
Health(APMG)
Sydney Office:
Suite108, 1
Erskineville
Road
Newtown 2042 AUSTRALIA
Ph: +612 9519 1039 Fax: 612 9517 2039Dave Burrows
dave@apmglobalhealth.com
http://
www.apmglobalhealth.com
Contact Details